经腹肠道超声与磁共振小肠造影对炎症性肠病狭窄诊断价值的比较

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关键词：炎症性肠病；肠道狭窄；经腹肠道超声；磁共振小肠造影；诊断一致性 中图分类号：R445.1文献标识码：A 文章编号：1000-503X（2025）05-0725-08 DOI：10.3881/j.issn.1000-503X.16850

ABSTRACT：ObjectiveTo compare the diagnostic value of transabdominal intestinal ultrasound（IUS） and magnetic resonance enterography（MRE）for intestinal stenosis in inflammatory bowel disease（IBD）. MethodsA retrospective analysis was conducted onthe imaging features of 51 IBD patients who underwent both IUS and MRE at Beijing Friendship Hospital，Capital Medical University，between January 2021 and February 2025. With endoscopyas thegold standard，thediagnosticperformanceof the two methods was compared.ResultsThesensitivity （ 84.2% Us. 52.6% ， P=0.008 ）and accuracy（ 66.7% Us. 45.1% ， P=0.035 ）of IUS for stenosis were higher than thoseof MRE.Inthe localization of stenosis，IUS demonstrated higher sensitivitythan MRE fordetecting stenosis in the terminal ileum （ 78.6% Us. 35.7% ， P=0.070 ）and colorectum（ 86.7% Us. 53.3% ， P= 0.060）.Furthermore，IUS showed higher diagnostic accuracy than MRE for terminal ileum stenosis（ 70.6% vS. （204号 29.4%，P=0.039 ）. The intestinal wall thickness[ （8.2±2.7） mm vs. （10.3±3.8） mm; t=3，20 ， P= 0.002）]and stenosis inner diameter （4.3±1.8）mm; t=2.15 ， P=0.035 measured by IUS were lower than those measured by MRE，with a moderate level of consistency（ICC：O.19-0.53）.In addition， IUS demonstrated a higher detection rate for mesenteric fat hypertrophy （ 70.6% vs. 27.5% ， Kappa= 0.27， P=0.005 ），whereas MRE was more sensitive in detecting lymphadenopathy （ 90.2% Us. 56.9% ，Kappa =0.16， P=0.080 ）. ConclusionsIUS is superior to MRE in the diagnosis and localization sensitivity for intestinal stenosis in IBD. However，the two methods showcase poor consistency in detecting and quantitating some inflammatory signs.IUS can be used as a first-line screening method for diagnosing intestinal stenosis in IBD patients，while its clinical application should be combined with specific needs to optimize diagnosis.

Keywords：inflammatoryboweldisease；intestinalstenosis；transabdominalintestinalultrasoud；magneticesonanceenter ography；diagnostic consistency

炎症性肠病（inflammatoryboweldisease，IBD）是一组病因未明的慢性非特异性肠道炎症性疾病，主要包括克罗恩病（Crohn’sdisease，CD）和溃疡性结肠炎（ulcerativecolitis，UC），其发病率在全球范围内呈上升趋势[1]。（剩余14183字）